Three hard hats for construction work lined up on a concrete wall

Enhancing Patient Safety Education and Training through Legal Study

By John Tingle

In the new NHS Patient Safety Strategy for England there is a discussion of patient safety education and training. While safety is now better understood there are significant numbers of people who still have a limited understanding of safety science.

A National Patient Safety Syllabus

A commitment is made to have a universal patient safety syllabus and training program for the whole of the NHS. Health Education England (HEE) will have a pivotal role: Read More

Illustration of a diverse group of people and health care workers

Q&A with Adam Lustig, Trust for America’s Health, on Laws to Promote Cost-Savings in States

By The Temple University Center for Public Health Law Research

This week, the Center for Public Health Law Research and Trust for America’s Health (TFAH) published the first two of 13 comprehensive datasets on laws that can support cost-savings for states and promote health and well-being. Researchers from Center used the scientific policy surveillance process to create datasets that provide states with detailed information about the current state of U.S. laws.

The first two datasets, covering syringe service programs (SSPs) and tobacco pricing strategies, offer an in-depth look at two harm reduction-focused laws that can also have a positive economic impact in communities.

We spoke with Adam Lustig, MS, the manager of the Promoting Health & Cost Control in States (PHACCS) project at TFAH.

CPHLR: These new datasets are the first two of 13, what other topics are being mapped, and how were these topics chosen?

Adam Lustig: We are incredibly excited for the release of the remaining eleven datasets through the summer of 2020. For a preview of things to come, we anticipate releasing datasets on Smoke-Free policies, Alcohol Pricing Strategies, Complete Streets, Ban the Box, and Earned Income Tax Credit in the first quarter of 2020. Following those datasets, we will publish the remaining datasets on School Nutrition Programs, Earned Sick Leave, Paid Family Leave, Rapid Re-Housing, Universal pre-K, and Housing Rehabilitation Loan and Grant Programs throughout the summer of 2020.

CPHLR: These first two datasets, and one forthcoming on alcohol pricing, focus specifically on harm reduction for substance use. Why are harm reduction strategies integral to cost control? Read More

Senior female woman patient in wheelchair sitting in hospital corridor with nurses and doctor

Care Quality Commission Annual Assessment of Health and Social Care

By John Tingle

The independent regulator for health and social care in England, the Quality Care Commission (CQC) has recently published its annual report on the real-time state of health and social care in England. It analyses trends, shares examples of outstanding, good, and poor health care care practices. It provides a true, unabashed account of issues facing the National Health Service (NHS) and health care delivery.

A Health System Stretched

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Photograph of memorial to victims of the El Paso, TX mass shooting

Pervasive Health Effects of Anti-Immigrant Rhetoric at the U.S.-Mexican Border

By Lilo Blank

The current xenophobic, racist, and anti-immigrant climate in the United States and its detrimental impact on immigrant communities and their health cannot be ignored. This month, gunmen have executed a series of mass shootings, including one specifically in El Paso, Texas, in which the gunman killed 22 people. The FBI is currently investigating the shooting as a suspected hate crime against immigrants. Terroristic acts of violence such as this are enough to incite fear in anyone, but especially in Hispanic communities on the border, who are facing additional forms of structural violence.

“Stigma is fundamentally about alienation and exclusion,” said stigma expert Dr. Daniel Goldberg, Associate Professor at the University of Colorado Anschutz Medical Campus’s Center for Bioethics and Humanities, in a recent interview. “Even when you control for access, people who are stigmatized get sicker and die quicker. And of course, we are social creatures. If stigma exists persistently and longitudinally, the more likely you are to be socially isolated, and social isolation is one of the most powerful predictors of mortality.”

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Photo of pencil case filled with colored pencils and an e-cigarette

Tracking Youth Electronic Cigarette Laws with Policy Surveillance

By Justine Fuga

Just last year, one in five high school students and one in 20 middle school students across the country used electronic cigarettes (e-cigarettes). According to the 2018 National Youth Tobacco Survey, more than 3.6 million middle and high school students used electronic cigarettes, more than double the number of youth using e-cigarettes in 2017. This increase is concerning given what is known about the adverse health effects of e-cigarettes. Recent research shows that nicotine has a negative effect on the developing brain. Other chemicals found in e-cigarettes are toxic to cells and have been linked to cardiovascular and lung diseases, including cancer.

Diverse strategies have emerged to curb the youth e-cigarette epidemic, including million-dollar campaigns from CVS Health and school policies implementing random nicotine testing. Most notable is the recent ordinance passed by San Francisco, the first city to institute a large-scale sales restriction. The city-wide ban prevents residents from purchasing any e-cigarettes in stores or online until products have undergone a premarket review by the U.S. Food and Drug Administration (FDA). The ban is motivated in part to decrease youth access to e-cigarettes. From 2016 to 2017, current e-cigarette use among California high school students increased from 8.6% to 10.9%, according to the California Student Tobacco Survey.The San Francisco ban is not the first law implemented to impact youth access to e-cigarettes. California state law sets various online purchasing requirements for e-cigarettes: online purchasers must provide proof of age, distributors must deliver to verified mailing addresses, and online purchaser age must be verified by a third-party service. These laws were in place in 2016 and 2017, but it is unclear whether these state laws had any impact on the 2.3% increase in youth vaping because, problematically, there is no current research exploring the link between the laws and youth e-cigarette use.

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Red stethoscope coiled in the shape of a heart

The NHS in England Launches a New Patient Safety Strategy

On July 2, 2019 a new National Health Service (NHS) patient safety strategy was launched in England. The strategy promises many things and lays out the future trajectory of NHS patient safety policy making.

Aidan Fowler, the NHS National Director of Patient Safety highlights the scale of the NHS patient safety problem in the foreword to the strategy:

 Too often in healthcare we have sought to blame individuals, and individuals have not felt safe to admit errors and learn from them or act to prevent recurrence…The opportunity is huge. Hogan et al’s research from 2015 suggests we may fail to save around 11,000 lives a year due to safety concerns, with older patients the most affected. The extra treatment needed following incidents may cost at least £1 billion (p3).

 

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NHS logo on the side of a building

Testing the Temperature of Patient Safety in the NHS

In terms of transparency and accountability the National Health Service ( NHS) in England is excellent at producing insightful, well-produced reports on health quality and patient safety. It does this on a regular basis and one of the great difficulties faced by NHS nurses and doctors today is the sheer volume of reports published. It’s an impossible task for nurses and doctors to keep up to date with all the reports published and to maintain heavy workloads in resource constrained environments. It’s also hard for health care staff to know which reports to prioritize and which are authoritative.

There is an urgent need for the NHS to create a one stop, patient safety information hub which collects reports from all NHS sites and other important global sites, putting everything into one accessible place. Some recent reports on written patient complaints have been published which are helpful in assessing, testing patient safety and health quality in the NHS. Read More

Polar chart depicting state conscience protection laws for abortion (46 states), sterilization (17 states), contraception (16 states), or emergency contraception (5 states).

New Dataset: Conscience Protections for Providers and Patients

Scholarship and public debate about law’s role in protecting health care providers’ conscience rights often focus on who should be protected, what actions should be protected, and when and whether there should be any limitations on conscience rights.

But the how of these legal protections is rarely addressed – that is, when health care providers decline to participate in medical services that violate their deeply-held beliefs, exactly what consequences do state laws protect them from? The new dataset I’ve just released on LawAtlas answers this question in the context of reproductive health conscience laws, and reveals some surprising trends.

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hand of a doctor holding a stethoscope

Patient Safety: The Urgent Need for Global Information Sharing and Learning

Patient harm is the 14th leading contributor to the global disease burden, according to a new report by WHO, OECD, and the World Bank.

In resource-constrained health care environments, it is important not to reinvent the wheel and waste money when existing, proven patient safety solutions already exist in other countries. Global patient safety knowledge sharing, and learning helps all countries, regardless of income level and this needs to be encouraged. Read More

Pro-choice and pro-life protesters face off in front of the Supreme Court

“Fetal Heartbeat” Bans are Gaining Momentum, but Abortion Restrictions Come in Many Forms

By Alexandra Hess

Alabama, Georgia, and Ohio have passed laws in recent weeks that ban many, if not all, abortions in their state. These bans are the latest additions to the litany of laws and policies that severely limit or totally prevent access to abortion for women in the United States.

“Fetal heartbeat” bans, like those enacted in both Ohio and Georgia, are some of the most restrictive types of gestational limitations on abortion in the U.S. They prohibit abortion at the point a fetal heartbeat is detectable by ultrasound—as early as six weeks’ gestation. This is often a point before many discover they are pregnant. Ohio and Georgia are not the first states to have enacted fetal heartbeat bans, however, and current legislative trends suggest they will not be the last. In 2019 alone, lawmakers have proposed heartbeat bans in at least 14 other state legislatures. Read More